Hi Kathleen,
Welcome to you! Sorry you have to be here after such a long break. Please check out the Melatonin thread as it may be beneficial if many of your attacks are at night. If there is one thing I have learnt over the years it's that just when you think you know the beast, it does a backflip and changes it behavior on you.
What flow rate on the O2 are you using? Many people give up on it, saying it doesn't work for them however the method in which it is used and the flow rates will determine its results, if administered incorrectly or not at atleast 15 liters/per minute flow rate ( 25-50 litres is much better) the results will not be anywhere as effective.
Some suggestions to help are:
Use the O2 as soon as you feel it coming on, Speed is the name of the game. The sooner you get on the O2, the better the success rate. Stay on it for 15 to 20 minutes. If it has not killed the hit, stop using it. Try to get through 10 minutes without the O2, and then hit it again. If the O2 does not work the first time, the second time is almost Kills the attack. Don't run out, always know how long your oxygen supply will last and how long it will take to get a resupply. At 12 lpm an E tank will only last 44 minutes. An H tank will last 8.3 hours. Here is a calculator to determine how long your oxygen supply will last:
http://www.monroecc.edu/depts/pstc/backup/paraoxca.htm
Once you have the O2, make sure you have the right accessories for proper delivery. Most can be bought off ebay relatively cheeply compared to hire costs. Don't count on anybody else to provide the Right Stuff. If you can't get a re-breathing mask you can use the nose prongs, Do not put it in your nose. Put it in your mouth, close your lips around it, and inhale. Open your mouth to exhale, and then close your lips, again, around it to inhale. Breath only through your mouth. Do not inhale any “room air” only the O2.
If you can't get a moisture bubbling bottle make one By using an empty clean jar, with a tight fitting lid, drill two small holes in the lid, the size of the O2 air line. Cut your hose, a foot or so from where it hooks to the tank. Stick the hose from the tank into the lid, and far enough down so that it touches the bottom of the jar. Take the hose that goes to the mask, and stick it into the other hole, but just far enough to stick through the lid. Seal around both hoses with a silicon type sealant. Put up to 5cm of distilled water (can be bought from chemist) into the jar. No more than ¼ full or when then O2 is on the water will come up the tube to the mask. Some people find putting ice into the moisturizer helps the O2 work quicker! If you do this only use distilled water to make the ice cubes.
If you are using a re-breather mask, hold it firmly to your face with the palm of your hand. When you inhale, place your index finger and thumb over and the holes on the side of the mask (the ones with the rubber valve over them), this is to make sure the valve seals fully over the nose and mouth. When you exhale, just lift the finger and thumb, keeping the mask to your face by the palm of your hand, let the air out of those holes. Alternatively you can lift the mask and exhale directly into the air but this cuts down on the purity of O2.
Leave the O2 on for 5 minutes AFTER the last of the pain is gone even if you have aborted an attack in 10 minutes or less just to be sure, if you take it off to soon, the attack could restart.AS with most things each person is different so what may work in one cluster may not work for the next, so if it doesn't work keep persevering, its trial and error, but you will figure it out eventually and O2 will become a very effective abortive for you! Please remember I'm not a Doctor or a Respiratory expert, this is just from experience and educating myself to get the best results from our oxygen.
Imigan injections are generally used at the beginning of an attack, if you wait until the point of going to the ER you are putting yourself through un-necessary pain. Some info on them is as follows:
The injections are 6mg each in 0.5ml and you get 2 per box. The recommended dosage is 2 injections per day which is 12mg ( I saw somewhere on this site that its 2 per week but that info is incorrect). The best was to get around this is by splitting the injections, some people can split them in to two others split them into three and get the same results as if using a full injection. As each person is different the amount required is also different, however the amounts do not change based on the severity of the headache eg. If you split the 6mg inj into 3 then it will have the same effect for a kip 5 headache as it would for a kip 10 headache and the time that it takes to work will also be the same. This info is from experience only!
As the injections only come in the one dosage of 6 mg the way that we split them is by using the 1ml single use insulin needles. The way I do this is after opening the injections out of the box and taking the sticker off the top, I open the flap as if I'm going to screw the injector pen on, I then get a butter knife and place it under the glass lip of ampule/inj, very carefully I pull upwards to get the ampule/inj out of the blue plastic surround. I then get the insulin needles and pull out the plunger part, I place the imigran amp needle into the top of the insulin needle syringe and with the plunger push down on the black seal on the inside of the imigran carefully until I have the right amount of Imigran in the insulin syringe (I only split them into 2 so its .25ml which is a 3mg dose). I remove the imigran and tilt the insulin syringe to the side slightly so I can reinsert the plunger, you must be very careful not to push it in to quickly or the imigran will squirt out the needle. When the plunger is in just far enough to seal, I turn it upside down and flick it with my finger so all the imigran goes to the bottom and the air to the top, allowing me to then push the plunger about half way up the syringe.
Then with each headache we use a subcutaneous inj ( into the fat layer just under the skin, the same as you would with the injector pen). By doing this we get 4 injections out of a kit rather than 2. If you split them into 3 then you would get 6 injections out of a kit. Which would mean you could treat all six headaches and still only have had the 12mg. It is unfortunate that they don't make the imigran in ampules (like morphine) in Australia or the injections in 2mg or 3mg doses. It makes sense to me that if you can use a smaller dose and get the same result then not only is it better for your health but also that you can treat more headaches without exceeding the recommended 12 mg a day dose. And lets not forget its heaps cheaper!
We have been doing this with the imigran for many years now and it has worked very well for us, please remember I'm not a doctor. If you have any queries just drop me a line. Hope this is helpful. Forgot to mention as the methods of imigran change so do the recommended doses per day. The maximum recommended doses are as follows:
Oral = 300mg per day Tablets
Nasal = 80mg per day Nasal sprays (4 spay packets per day)
IM = 12mg per day Subcutaneous Injections (2 x 6mg or 4x3mg or 6x2mg inj)
Wishing you all the best and pain free times!
Regards Shell
This post was edited on 07/12/2010 at 10:43 pm
yes I did mean O2 - the other seems like an easy way out. The imigran is the injections and there are only two so I'm not sure if I will know that a particular attack is going to be the one to use one of the injections on or try to weather the storm. Years ago I used to go to ER if I had three attacks during a night (usually escallating in severity) in those day if I had a shot of pethadine I could sleep CH free for 10 or 12 hours. I presume that I would use the imigran at the point where I used to give up and want to go to the ER.
so finally had about 5 hours sleep, feeling a lot more human this morning. Might not be as 
at my kids today. We started school holidays on Wednesday this week - it is going to be a long 9 weeks of holidays if the nights are filled with CH 
I'd better make the most of today. My youngest boy has gymnastics classes this morning and gymnastics comp this arvo. Older son in swimming comp this arvo. They both want to have friends sleep over on Sunday night but I'm a bit nervous of having others around during my episode - I'm sure to scare the children if they see me.
